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选择性细胞保留技术获取的富集骨髓在治疗青少年特发性脊柱侧凸中的临床应用。

The clinical use of the enriched bone marrow obtained by selective cell retention technology in treating adolescent idiopathic scoliosis.

作者信息

Yang Peng, Xing Junchao, Chen Beike, Luo Fei, Zhang Zehua, Xu Jianzhong, Hou Tianyong

机构信息

National & Regional United Engineering Lab of Tissue Engineering, Department of Orthopaedics, Southwest Hospital, The Third Military Medical University, Chongqing, China.

Center of Regenerative and Reconstructive Engineering Technology in Chongqing City, Chongqing, China.

出版信息

J Orthop Translat. 2020 Mar 5;27:146-152. doi: 10.1016/j.jot.2020.02.005. eCollection 2021 Mar.

Abstract

PURPOSE

This retrospective study aimed to evaluate the curative effect of allografts in combination with bone marrow enrichment realised by selective cell retention (SCR) technology in treating adolescent idiopathic scoliosis (AIS).

METHODS

From July 2014 to September 2016, 18 consecutive patients with AIS were treated by posterior fusion and pedicle screw instrumentation. Bone marrow aspirates were obtained and enriched by SCR technology to fabricate bone grafts in combination with allogeneic bones, which were implanted for spinal fusion. Postoperatively, the patients were observed for a minimum of 18 months, with a mean follow-up period of 48 months. The results were assessed both clinically and radiographically. All adverse events and complications were recorded.

RESULTS

A total of 9 male and 9 female patients were included, with an average age of 15.6 years (range, 12-20). The average preoperative Cobb angle was 56° (range, 47°-85°). The average number of levels fused was 11 (range, 9-13). SCR could be accomplished intraoperatively, only consuming approximately 20 ​min. The enriching multiples of measured cellular elements were approximately 2.3-4.2. At final follow-up, the average Cobb angle correction was 83% (range, 61-96%). There was no obvious loss in correction with an average loss of 1.1° (2%). The visual analogue scale score and the Oswestry Disability Index score at final follow-up were significantly ameliorated than those preoperatively. The Scoliosis Research Society 30 questionnaire revealed remarkable improvement in the domains "pain", "self-image/appearance", and "satisfaction with management". There was neither pseudarthrosis nor severe complication.

CONCLUSION

The use of SCR technology could be considered as an effective method for promoting spinal fusion in treating AIS. We proposed a safe, simple, and rapid approach to obtain effective bone grafts for spinal fusion.

THE TRANSLATIONAL POTENTIAL OF THIS ARTICLE

Enriched bone marrow obtained by selective cell retention technology has the potential to promote spinal fusion for the treatment of adolescent idiopathic scoliosis.

摘要

目的

本回顾性研究旨在评估采用选择性细胞保留(SCR)技术实现骨髓富集的同种异体移植物治疗青少年特发性脊柱侧凸(AIS)的疗效。

方法

2014年7月至2016年9月,18例连续的AIS患者接受后路融合及椎弓根螺钉内固定治疗。获取骨髓抽吸物并通过SCR技术进行富集,以制备与同种异体骨联合的骨移植物,用于脊柱融合。术后,对患者进行至少18个月的观察,平均随访期为48个月。从临床和影像学两方面评估结果。记录所有不良事件和并发症。

结果

共纳入9例男性和9例女性患者,平均年龄15.6岁(范围12 - 20岁)。术前平均Cobb角为56°(范围47° - 85°)。平均融合节段数为11个(范围9 - 13个)。SCR可在术中完成,仅耗时约20分钟。所测细胞成分的富集倍数约为2.3 - 4.2。末次随访时,平均Cobb角矫正率为83%(范围61% - 96%)。矫正无明显丢失,平均丢失1.1°(2%)。末次随访时视觉模拟量表评分和Oswestry功能障碍指数评分较术前显著改善。脊柱侧凸研究学会30项问卷显示在“疼痛”、“自我形象/外观”和“对治疗的满意度”方面有显著改善。未出现假关节形成或严重并发症。

结论

可考虑将SCR技术作为治疗AIS促进脊柱融合的有效方法。我们提出了一种安全、简单且快速的方法来获取用于脊柱融合的有效骨移植物。

本文的转化潜力

通过选择性细胞保留技术获得的富集骨髓有促进脊柱融合以治疗青少年特发性脊柱侧凸的潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c714/8071651/88fa3e1aeed3/gr1.jpg

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